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SAFELY EMBRACING CULTURE: THE ADEQUACY OF THE CULTURAL SAFETY PARADIGM...
may help learning, but are not guaranteed to improve practice. As such, the
cultural safety paradigm, despite being vague, may have design characteristics
that lose their power outside of a nursing or educational context.
Despite all of the aforementioned possible concerns, cultural safety has been
argued to be efficacious in both Canada* * and the U.S. healthcare systems.
However, this efficacy must be taken with a grain of salt. As with any measure
of success, the efficacy of the cultural safety paradigm must be measured
relative to some metric set out by its users (after all, the paradigm lacks an
accountability framework to measure itself by). In Canada and the U.S., this
metric is the amount of knowledge on Indigenous cultures the paradigm
garners. Put differently, the appropriated form of cultural safety prioritizes
ethnographic knowledge, which is not the same as cultural understanding.
Indeed, an ethnographic focus is very reminiscent of the historically proven
ineffective primacy of Indigenous bodies, rather than Indigenous persons.”
There are a myriad of examples of this ethnographic overreliance, which
include, but are not limited to: a proclivity of medical research to conduct
descriptive studies on Indigenous populations, rather than measurement
or intervention-based studies.*® *” Indigenous specific adverse childhood
experience diagnostics,“ selectively screening for intergenerational trauma
in physician encounters,”” and inadequately engaging target individuals
in community-based participatory research projects.’ These sorts of
knowledge pursuits are not completely devoid of usefulness, but they lead us
to conceptualize “understanding” in a problematically narrow way. It is here
where the appropriated form of cultural safety moves from possible to very
real concerns.
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Lynden Lindsay Crowshoe et al., Exploring Canadian Physicians’ Experiences with Type 2
Diabetes Care for Adult Indigenous Patients, Canadian Journal of Diabetes, Vol. 42, No. 3
(2018), 281-288.
3 Rachelle D. Hole et al., Visibility and Voice: Aboriginal People Experience Culturally Safe
and Unsafe Health Care, Qualitative Health Research, Vol. 25, No. 12 (2015), 1662-1674.
4 Dawn Doutrich et al, Cultural Safety in New Zealand and the United States: Looking at a
Way Forward Together, Journal of Transcultural Nursing, Vol. 23, No. 2 (2012), 143-150.
Maureen K. Lux, Seperate Beds, 29.
16 Alika Lafontaine, Indigenous Health Disparities: A Challenge and an Opportunity,
Canadian Journal of Surgery, Vol. 61, No. 5 (2018), 300-301.
# Robert Sanson-Fisher et al., Indigenous Health Research : A Critical Review of Outputs over
Time, The Medical Journal of Australia, Vol. 184, No. 10 (2006), 502-505.
18 David Finkelhor et al, A Revised Inventory of Adverse Childhood Experiences, Child Abuse
& Neglect, Vol. 48 (2015), 13-21.
© Amy Bombay — Kimberly Matheson — Hymie Anisman, The Intergenerational Effects of
Indian Residential Schools: Implications for the Concept of Historical Trauma, Transcultural
Psychiatry, Vol. 51, No. 3 (2014), 320-338, https://doi.org/10.1177/1363461513503380
(accessed 5 December 2020).
5° Eileen Pittaway — Linda Bartolomei — Richard Hugman, Stop Stealing Our Stories: The Ethics
of Research with Vulnerable Groups, Journal of Human Rights Practice, Vol. 2, No. 2 (2010),
229-251.
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